Southern medical journal
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Southern medical journal · May 2023
ReviewDirect Use of Clinical Tolerance Limits for Assessing the Degree of Agreement between Two Methods of Measuring Blood Pressure.
A large number of new methods of measuring blood pressure (BP) have recently emerged with advances in technology. Different methods of measuring BP generally provide varying readings compared with one another. Clinicians must decide how to respond to these variations and how to assess the degree of agreement. ⋯ This method requires a comparison of Bland-Altman limits with the prespecified clinical tolerance limits. This review describes an alternative simple and robust method that directly uses clinical tolerance limits for assessing agreement without calculating Bland-Altman limits. The many advantages of this method are illustrated with the help of real-life examples of BP measurements.
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Southern medical journal · May 2023
Impact of Preoperative Echocardiograms on In-Hospital Outcomes of Patients Undergoing Surgical Hip Fracture Repair and Their Clinical Appropriateness.
Preoperative transthoracic echocardiograms (TTE) before hip fracture repairs are controversial. This study aimed to quantify the frequency of ordering TTE, the appropriateness of testing based on current guidelines, and the impact of TTE on in-hospital morbidity and mortality outcomes. ⋯ Patients subjected to TTE before hip fracture surgery had a longer LOS and time to surgery, with higher mortality and intensive care unit up triage rates. TTE evaluations were typically conducted for inappropriate indications, which rarely made meaningful changes to patient management.
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Southern medical journal · May 2023
Building Better Patient Care in Mississippi Radiation Oncology: Why Mississippi Needs a Collaborative Quality Initiative.
Cancer is an insidious and devastating disease that affects many people. Progress in mortality rate has not been realized universally across the United States, and challenges remain in how to best make up the ground that has been lost in these areas, one of which is Mississippi. Radiation therapy is a significant contributor to cancer control rates and certain challenges exist specifically regarding this treatment modality. ⋯ Significant barriers exist in the state of Mississippi to patients receiving a consistent standard of care, regardless of their location and socioeconomic status. A collaborative quality initiative has been shown to be a boon to this endeavor elsewhere and stands to have a similar impact in Mississippi.
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The purpose of this study was to describe the local communities served by major teaching hospitals. ⋯ Our analysis suggests that the local population surrounding MTHs is representative of the wide-ranging ethnic and economic diversity of the US population that is advantaged in some ways and disadvantaged in others. MTHs continue to play an important role in caring for a diverse population. To support and improve policy related to the reimbursement of uncompensated care and care of underserved populations, researchers and policy makers must work to better delineate and make transparent local hospital markets.
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Southern medical journal · May 2023
ReviewConvalescent Plasma Therapy in Late-State, Severe COVID-19 Infection.
Current evidence favors plasma to be effective against coronavirus disease 2019 (COVID-19) in critically ill patients in the early stages of infection. We investigated the safety and efficacy of convalescent plasma in specifically late-stage (designated as after 2 weeks of hospital admission) severe COVID-19 infection. We also conducted a literature review on the late-stage use of plasma in COVID-19. ⋯ This case series provides evidence that convalescent plasma may be safe and effective in late-stage, severe COVID-19 infection. Results showed clinical improvement posttransfusion as well as decreased all-cause mortality in comparison to pretransfusion predicted mortality. Randomized controlled trials are needed to conclusively determine benefits, dosage, and timing of treatment.